title: Retiform purpura: a new stigmata of illicit drug use?
abstract: We report a 50-year-old woman who presented with a six-month history of recurrent retiform purpura of uncertain etiology. Laboratory findings included neutropenia, positive anticardiolipin IgM antibody, and a weakly positive p-ANCA. Histopathology revealed a leukocytoclastic vasculitis with intravascular thrombi. Urine toxicology screen was positive for cocaine. These findings are similar to recent reports of agranulocytosis and purpura induced by levamisole-tainted cocaine. A review of the clinical and histopathological findings associated with levamisole-induced purpura will be discussed.
authors.affiliation: Department of Dermatology, Mount Sinai Medical Center, New York, New York, USA. Lauren.Geller@mssm.edu
authors.forename: Lauren
authors.initials: L
authors.lastname: Geller
authors.forename: Talley B
authors.initials: TB
authors.lastname: Whang
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Mercer
authors.forename: Robert
authors.initials: R
authors.lastname: Phelps
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D019970:Cocaine-Related Disorders / Q000150:complications*; D004340:Drug Contamination; D004431:Ear, External / Q000473:pathology; D005260:Female; D006801:Humans; D007978:Levamisole / Q000009:adverse effects*; D008875:Middle Aged; D011693:Purpura / Q000139:chemically induced / Q000473:pathology*; D014657:Vasculitis / Q000139:chemically induced / Q000473:pathology*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D007978:Levamisole